The Feasibility of Using a Smartphone Magnetometer for Assisting Needle Placement

Minimally invasive surgical procedures often require needle insertion. For these procedures, efficacy greatly depends on precise needle placement. Many methods, such as optical tracking and electromagnetic tracking, have been applied to assist needle placement by tracking the real-time position information of the needle. Compared with the optical tracking method, electromagnetic tracking is more suitable for minimally invasive surgery since it has no requirement of line-of-sight. However, the devices needed for electromagnetic tracking are usually expensive, which will increase the cost of surgery. In this study, we presented a low-cost smartphone-based permanent magnet tracking method compatible with CT imaging and designed a 3D printed operation platform to assist with needle placement prior to needle insertion during minimally invasive surgery. The needle positioning accuracy of this method was tested in an open air test and a prostate phantom test in a CT environment. For these two tests, the average radial errors were 0.47 and 2.25 mm, respectively, and the standard deviations were 0.29 and 1.63, respectively. The materials and fabrication required for the presented method are inexpensive. Thus, many image-guided therapies may benefit from the presented method as a low-cost option for needle positioning prior to needle insertion

MRI robot for prostate focal laser ablation : An ex vivo study in human prostate

Purpose: A novel grid-template-mimicking MR-compatible robot was developed for in-gantry MRI-guided focal laser ablation of prostate cancer. Method: A substantially compact robot was designed and prototyped to meet in-gantry lithotomy ergonomics and allow for accommodation in the perineum. The controller software was reconfigured and integrated with the custom-designed navigation and multi-focal ablation software. Three experiments were conducted: (1) free space accuracy test; (2) phantom study under computed tomography (CT) guidance for image-guided accuracy test and overall workflow; and (3) magnetic resonance imaging (MRI)-guided focal laser ablation of an ex vivo prostate. The free space accuracy study included five targets that were selected across the workspace. The robot was then commanded five times to each target. The phantom study used a gel phantom made with color changing thermos-chromic ink, and four spherical metal fiducials were deployed with the robot. Then, laser ablation was applied, and the phantom was sliced for gross observation. For an MR-guided ex vivo test, a prostate from a donor who died of prostate cancer was obtained and multi-focally ablated using the system within the MRI gantry. The tissue was sliced after ablation for validation. Results: free-space accuracy was 0.38 ± 0.27 mm. The overall system targeting accuracy under CT guidance (including robot, registration, and insertion error) was 2.17 ± 0.47 mm. The planned ablation zone was successfully covered in both acrylamide gel phantom and in human prostate tissue. Conclusions: The new robot can accurately facilitate fiber targeting for MR-guided focal laser ablation of targetable prostate cancer

Original Articles PERCUTANEOUS RADIO FREQUENCY ABLATION OF SMALL RENAL TUMORS: INITIAL RESULTS

ABSTRACT Purpose: Thermal tissue ablation with radio frequency energy is an experimental treatment of renal tumor. We report early results of an ongoing trial of percutaneous radio frequency ablation for small renal tumors. Materials and Methods: Patients with percutaneously accessible renal tumors were evaluated for radio frequency ablation. Tumors were solid on computerized tomography (CT), 3 cm. or less in diameter and enlarging during at least 1 year. Ablation was performed at the Interventional Radiology suite under ultrasound and/or CT guidance. A 50 W., 460 kHz. electrosurgical generator delivered radio frequency energy via a percutaneously placed 15 gauge coaxial probe. At least 2, 10 to 12-minute ablation cycles were applied to each lesion. Patients were observed overnight before discharge from hospital and reevaluated 2 months later. Results Conclusions: Percutaneous radio frequency ablation of small renal tumor is well tolerated and minimally invasive. It will remain experimental until procedural and imaging parameters that correlate with tumor destruction are validated

Image-guided focal therapy for prostate cancer

The adoption of routine prostate specific antigen screening has led to the discovery of many small and low-grade prostate cancers which have a low probability of causing mortality. These cancers, however, are often treated with radical therapies resulting in long-term side effects. There has been increasing interest in minimally invasive focal therapies to treat these tumors. While imaging modalities have improved rapidly over the past decade, similar advances in image-guided therapy are now starting to emerge—potentially achieving equivalent oncologic efficacy while avoiding the side effects of conventional radical surgery. The purpose of this article is to review the existing literature regarding the basis of various focal therapy techniques such as cryotherapy, microwave, laser, and high intensity focused ul­trasound, and to discuss the results of recent clinical trials that demonstrate early outcomes in patients with prostate cancer

D\u27Amico Risk Stratification Correlates with Degree of Suspicion of Prostate Cancer on Multiparametric Magnetic Resonance Imaging.

PURPOSE: We determined whether there is a correlation between D\u27Amico risk stratification and the degree of suspicion of prostate cancer on multiparametric magnetic resonance imaging based on targeted biopsies done with our electromagnetically tracked magnetic resonance imaging/ultrasound fusion platform. MATERIALS AND METHODS: A total of 101 patients underwent 3 Tesla multiparametric magnetic resonance imaging of the prostate, consisting of T2, dynamic contrast enhanced, diffusion weighted and spectroscopy images in cases suspicious for or with a diagnosis of prostate cancer. All prostate magnetic resonance imaging lesions were then identified and graded by the number of positive modalities, including low-2 or fewer, moderate-3 and high-4 showing suspicion on multiparametric magnetic resonance imaging. The biopsy protocol included standard 12-core biopsy, followed by real-time magnetic resonance imaging/ultrasound fusion targeted biopsies of the suspicious magnetic resonance lesions. Cases and lesions were stratified by the D\u27Amico risk stratification. RESULTS: In this screening population 90.1% of men had a negative digital rectal examination. Mean±SD age was 62.7±8.3 years and median prostate specific antigen was 5.8 ng/ml. Of the cases 54.5% were positive for cancer on protocol biopsy. Chi-square analysis revealed a statistically significant correlation between magnetic resonance suspicion and D\u27Amico risk stratification (p CONCLUSIONS: Our data support the notion that using multiparametric magnetic resonance prostate imaging one may assess the degree of risk associated with magnetic resonance visible lesions in the prostate

Deeply virtual and exclusive electroproduction of omega mesons

The exclusive omega electroproduction off the proton was studied in a large kinematical domain above the nucleon resonance region and for the highest possible photon virtuality (Q2) with the 5.75 GeV beam at CEBAF and the CLAS spectrometer. Cross sections were measured up to large values of the four-momentum transfer (-t < 2.7 GeV2) to the proton. The contributions of the interference terms sigma_TT and sigma_TL to the cross sections, as well as an analysis of the omega spin density matrix, indicate that helicity is not conserved in this process. The t-channel pi0 exchange, or more generally the exchange of the associated Regge trajectory, seems to dominate the reaction gamma* p -> omega p, even for Q2 as large as 5 GeV2. Contributions of handbag diagrams, related to Generalized Parton Distributions in the nucleon, are therefore difficult to extract for this process. Remarkably, the high-t behaviour of the cross sections is nearly Q2-independent, which may be interpreted as a coupling of the photon to a point-like object in this kinematical limit.Comment: 15 pages,19 figure

Q^2 Dependence of the S_{11}(1535) Photocoupling and Evidence for a P-wave resonance in eta electroproduction

New cross sections for the reaction $ep \to e'\eta p$ are reported for total center of mass energy $W$=1.5--2.3 GeV and invariant squared momentum transfer $Q^2$=0.13--3.3 GeV$^2$. This large kinematic range allows extraction of new information about response functions, photocouplings, and $\eta N$ coupling strengths of baryon resonances. A sharp structure is seen at $W\sim$ 1.7 GeV. The shape of the differential cross section is indicative of the presence of a $P$-wave resonance that persists to high $Q^2$. Improved values are derived for the photon coupling amplitude for the $S_{11}$(1535) resonance. The new data greatly expands the $Q^2$ range covered and an interpretation of all data with a consistent parameterization is provided.Comment: 31 pages, 9 figure